Abstract
Bronchoalveolar lavage (BAL) is used in the diagnosis of interstitial lung diseases. BAL is diagnostic when ≥ 60% of the instilled volume is recovered. There are no reliable markers useful to predict whether BAL volume is going to be diagnostic. Our goal was to search for pulmonary function markers which could anticipate whether the recovered volume of instilled fluid would be ≥ 60% of administered volume. BAL volumes and quality were analyzed in the context of disease, medical condition and lung function test results of the subjects hospitalized at the Pulmonology Ward from January 2015 to October 2016. The patients' average age was 61 (29-89). Among 80 procedures, diagnostic BAL (≥ 60%) has been obtained in 58 cases. The analysis of the group of patients with an interstitial lung disease confirmed that there is a correlation between decreasing BAL recovered volume and an increase of RV[%pred] (r = -0.34) and RV/TLC[%pred] (r = -0.41); p < 0.05. There was no significant correlation with DLCO. RV/TLC[%pred] was the parameter with the highest predictive value for an anticipated correct BAL recovery. The curve analysis of the receiver operating characteristic (ROC) showed a diagnostic accuracy (AUC 0.73, 95% CI 0.61-0.86). Pulmonary hyperinflation may have a predictive role in anticipating a proper recovery of the BAL fluid volume.
Highlights
Bronchoalveolar lavage (BAL) is used in the diagnosis of interstitial lung diseases
Interstitial lung diseases (ILDs) constitute a very heterogeneous group of non-infectious and non-cancerous illnesses, which includes more than 200 disease entities of a similar clinical, radiological and pathophysiological picture [1, 2]
Study group The retrospective analysis included the patients with interstitial lung disease from the Department of Pneumonology who have undergone bronchoalveolar lavage (BAL) procedure in the period between January 2015 and October 2016
Summary
Bronchoalveolar lavage (BAL) is used in the diagnosis of interstitial lung diseases. The analysis of the group of patients with an interstitial lung disease confirmed that there is a correlation between decreasing BAL recovered volume and an increase of RV[%pred] (r = –0.34) and RV/TLC[%pred] (r = –0.41); p < 0.05. Individual disease entities do not occur very often, but all ILDs account for about 16% of the respiratory system diseases [2] It means that their correct diagnosis, differentiation and, effective treatment are an essential task for physicians. The diagnostic approach includes: clinical history and examination, pulmonary function tests, selective blood tests, imaging examinations: chest radiography and high resolution computed tomography, bronchoscopy with bronchoalveolar lavage (BAL) and/or endobronchial/transbronchial biopsies and/or a surgical biopsy [4]. A medical procedure that allows to obtain material from the bronchoalveolar space is BAL performed during
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